DR. JACQUELINE MARY QUINN-TAN PSY.D.
NPI 1518111996
Psychologist - Clinical in South Bend, IN

Q: What is Jacqueline Quinn-tan's NPI number?

The NPI number for Jacqueline Quinn-tan is 1518111996. It was assigned to this individual provider in the NPPES registry on November 11, 2008.

Q: What is Jacqueline Quinn-tan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since November 11, 2008PECOS Enrolled

1000 S MICHIGAN ST, SOUTH BEND, IN 46601(574) 235-5408 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Jacqueline Mary Quinn-tan Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE MARY QUINN-TAN PSY.D. (NPI 1518111996) is an individual clinical provider in South Bend, Indiana, licensed in Indiana (20041167A) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518111996

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JACQUELINE MARY QUINN-TANCredential: PSY.D.

Location Address1000 S MICHIGAN STSouth Bend, IN 46601-3426

Mailing Address1540 Trinity PlMishawaka, IN 46545-5006 · (574) 272-9000

Phone(574) 235-5408

Sole ProprietorYes

Enumeration DateNovember 11, 2008

Last NPPES UpdateAugust 25, 2021

NPPES CertifiedAugust 25, 2021

✔ NPI 1518111996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IN · 20041167A

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1000 S MICHIGAN ST, South Bend, IN 46601

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacqueline Mary Quinn-tan Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$161.76 typical visit price

range $53.07 – $161.76

Typical copayment $40.44 (range $13.26 – $40.44)

Most-billed visit code 99205

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RITE OF PASSAGE, INC.

Residential Treatment Facility, Emotionally Disturbed Children

1000 S MICHIGAN ST
SOUTH BEND, IN 46601

St. Joseph County (574) 339-4419

IKE SHIPMAN

Counselor (Mental Health)

1000 S MICHIGAN ST
SOUTH BEND, IN 46601

St. Joseph County (574) 235-5427

WILLIAM BRUINSMA PSYD

Psychologist

1000 S MICHIGAN ST
SOUTH BEND, IN 46601

St. Joseph County (574) 339-4419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Quinn-tan's NPI number?

The NPI number for Jacqueline Quinn-tan is 1518111996. It was assigned to this individual provider in the NPPES registry on November 11, 2008.

Where is Jacqueline Quinn-tan located?

Jacqueline Quinn-tan practices at 1000 S Michigan St, South Bend, IN 46601. The listed phone number is (574) 235-5408.

What is Jacqueline Quinn-tan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jacqueline Quinn-tan enrolled in Medicare?

Yes. Jacqueline Quinn-tan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Quinn-tan was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.